Organization Active NPI

Primary Critical Care Limited Partnership

  • Emergency Medicine Physician
  • Fallbrook, CA
National Provider Identifier
1467417030
Registry record updated Feb 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
G53318 Issued in CA
Legal business name
PRIMARY CRITICAL CARE LIMITED PARTNERSHIP
Practice address
624 E Elder St
Fallbrook, CA 92028-3004
Phone
(760) 728-1191
NPI assigned
Apr 18, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Bruce T Gipe, MD
Title
President and General Partner
Phone
(818) 509-2222

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207P00000X G53318 CA Primary

Addresses

Primary practice location

624 E Elder St
Fallbrook, CA 92028-3004

Mailing address

PO Box 998
North Hollywood, CA 91603-0998
Phone (818) 509-2222

Other identifiers 1

IdentifierTypeStateIssuer
GR0088730MedicaidCA

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1145318400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1204156800000",
    "number": "1467417030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 998",
            "city": "NORTH HOLLYWOOD",
            "state": "CA",
            "postal_code": "916030998",
            "telephone_number": "818-509-2222",
            "fax_number": "818-761-3458"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "624 E ELDER ST",
            "city": "FALLBROOK",
            "state": "CA",
            "postal_code": "920283004",
            "telephone_number": "760-728-1191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIMARY CRITICAL CARE LIMITED PARTNERSHIP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-18",
        "last_updated": "2008-02-28",
        "status": "A",
        "authorized_official_last_name": "GIPE",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "PRESIDENT AND GENERAL PARTNER",
        "authorized_official_telephone_number": "818-509-2222",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "G53318",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0088730",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fallbrook, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.